Provider First Line Business Practice Location Address:
652 CARRETERA 28
Provider Second Line Business Practice Location Address:
METROPOLITAN DETENTION CENTER
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00962-5700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-775-7927
Provider Business Practice Location Address Fax Number:
787-775-7994
Provider Enumeration Date:
05/21/2007